Wednesday, June 12, 2019

Pa. nursing homes get ’F’ from national group

Pennsylvania
nursing homes on Monday received a failing grade from a national
advocacy group, which gave it one of the worst report cards in the
nation.

Families for Better Care based its report card on eight measures collected
by the federal government. These include number of problems found
during government inspections, staffing levels and number of verified
complaints. Pennsylvania ranked among the bottom ten states in measures
including staffing hours per resident, number of facilities with
deficiencies and portion of homes rated as average or worse than average
by Medicare.

“A
great way for Governor Wolf and Pennsylvania lawmakers to improve
nursing home safety is by passing a tough staffing standard, something
the residents sorely need,” he said in a news release. “But a new
staffing standard isn’t enough, lawmakers must find a way to help
nursing homes pay for any new staffing mandate if care is to improve at
all.”

Pennsylvania
ranked 46th among the states, down from 32nd in 2014, the year of
Families for Better Care’s previous report card. Pennsylvania received a
D in 2014.

Texas ranked worst, ahead
of North Carolina, Illinois, Georgia, New Mexico and Pennsylvania. The
best grades went to Hawaii, Delaware, Alaska, Rhode Island and Utah.

Pennsylvania
received better than a D for only two of the eight measures. It
received a C for its proportion of homes with severe deficiencies,
placing it roughly in the middle of the pack nationally. Still, that’s a
significant drop from 2014, when Pennsylvania received an A and ranked
eighth-best.

Pennsylvania’s best mark, a B, came in the
area of professional nursing hours per resident. It’s rate of 1.83
professional nursing hours per resident was good for 16th place, down
slightly from four years ago.

However, the 2.24 hours of daily direct care for residents of Pennsylvania homes put it near the bottom, at 47th.

Zach Shamberg, the CEO of the Pennsylvania
Health Care Association, which represents nursing homes, said the
report card is based on 2017 data. In 2018, he said, Pennsylvania
nursing homes showed significant improvement in a few measures,
including the number of homes with severe deficiencies.

But
in an interview, he focused on funding shortages which he said impact
homes’ ability to care for residents. Seventy percent of Pennsylvania
nursing home residents are covered by Medicaid, the state-federal
program for people with lower incomes. Medicaid funding hasn’t increased
since 2014, with the average Pennsylvania home receiving $27.25 per day
less than the cost of caring for each resident, according to Shamberg.

As
a result, homes have trouble competing for workers, especially with the
present historically low unemployment rate, according to Shamberg.
“Frankly, right now we can’t find them … there is a workforce crisis
around Pennsylvania and around the country.”

But rather than raising wages to attract more workers, Shamberg said the solution is more about “training and competency.”

It’s no secret nursing homes in Pennsylvania are struggling to provide adequate levels of certified nursing assistants,
or CNAs, who provide most of the care for nursing home recents. At a
recent hearing held by Pennsylvania lawmakers, representatives of
nursing homes and a union representing CNAs agreed homes face a staffing
crisis. They further agreed the crisis is the result of low wages paid
to CNAs, with the wage crisis stemming from long-stagnant state payments
for nursing home care. They stressed the typical nursing home resident
has grown steadily sicker and in need of more care, but payments haven’t
risen accordingly.

Union
representatives agreed on the need for more funding, but urged lawmakers
to give increases only to homes that are willing to spending it on
staffing, not profit. The union also wants the state to set a minimum
level of hours of care per resident, which the nursing home industry
opposes.

The Pennsylvania Department of Health
believes the homes’ poor grade and the drop in national ranking is due
in part to increased state oversight and penalties against nursing
homes, according to spokesman Nate Wardle.

If one state inspects and its penalizes its home more vigorously than another, that could result in its homes appearing worse.

In
April, Wardle said, there were 541 inspections of 369 nursing homes,
and 312 complaint investigations, resulting in fines penalties of more
then $206,000 in penalties.

Beyond
that, Gov. Tom Wolf supports mandated staffing levels, and has also
assembled a group to look for policies that will improve nursing home
safety, Wardle said.

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